How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $645.65 | Facility | None | $269.15 | $269.15 | $645.65 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $398.11 | Professional | None | $269.15 | $269.15 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $275.42 | Facility | None | $269.15 | $269.15 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
CDPHP Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $275.42 Typical High $467.74 | Facility | None | $269.15 | $275.42 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $1,288.25 | Professional | None | $269.15 | $269.15 | $1,288.25 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $575.44 | Facility | None | $251.19 | $331.13 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $316.23 | Professional | None | $269.15 | $275.42 | $316.23 |
Excellus BCBS Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | None | $251.19 | $251.19 | $269.15 |
MVP Health Care Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $501.19 | Facility | None | $331.13 | $331.13 | $501.19 |
MVP Health Care Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $323.59 | Professional | None | $213.80 | $213.80 | $323.59 |
United Setting Facility Modifier None Typical Low $245.47 Median $257.04 Typical High $288.40 | Facility | None | $245.47 | $257.04 | $288.40 |
United Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $363.08 | Professional | None | $239.88 | $281.84 | $363.08 |
Univera Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $263.03 | Facility | None | $251.19 | $251.19 | $263.03 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | None | $251.19 | $251.19 | $269.15 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Where New York sits
The same service costs 2.3 times more in Arizona than in Alabama. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 48th of 51
$251
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.